Provider Demographics
NPI:1174657704
Name:DELAWARE REHABILITATION SERVICES NETWORK, INC.
Entity Type:Organization
Organization Name:DELAWARE REHABILITATION SERVICES NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RECORDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, ATC
Authorized Official - Phone:302-836-8287
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4773
Mailing Address - Country:US
Mailing Address - Phone:302-836-8287
Mailing Address - Fax:302-836-5536
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:302-836-8287
Practice Address - Fax:302-836-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE19D225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty